Protective role of physical activity patterns prior to COVID-19 confinement with the severity/duration of respiratory pathologies consistent with COVID-19 symptoms in Spanish populations

Higher level of physical activity reduces mental and neurological symptoms during and two years after COVID-19 infection in young women

Previous studies found that regular physical activity (PA) can lower the risk of SARS-CoV-2 (COVID-19) infection and post-COVID-19 condition (PCC), yet its specific effects in young women have not yet been investigated. Thus, we aimed to examine whether regular physical activity reduces the number of symptoms during and after COVID-19 infection among young women aged between 18 and 34 (N = 802), in which the confounding effect of other morbidities could be excluded. The average time since infection was 23.5 months. Participants were classified into low, moderate, and high PA categories based on the reported minutes per week of moderate and vigorous PA. Using the Post-COVID-19 Case Report Form, 50 different symptoms were assessed. Although regular PA did not decrease the prevalence of COVID-19 infection and PCC but significantly reduced the number of mental and neurological symptoms both in acute COVID-19 and PCC. Importantly, the high level of PA had a greater impact on health improvements. In addition, the rate of reinfection decreased with an increased level of PA. In conclusion, a higher level of regular PA can reduce the risk of reinfection and the number of mental and neurological symptoms in PCC underlying the importance of regular PA, even in this and likely other viral disease conditions.

Changes in lifestyle and physical and mental health related to long-confinement due COVID-19: a study during the first and second pandemic waves in Mexico and Chile

We investigate changes in lifestyle, physical, and mental health during the confinement period of the first and second waves of COVID-19, as well as their relation to sociodemographic parameters and confinement status. Sociodemographic data and information regarding changes in their lifestyle behavior and changes in body weight and physical activity (PA) were collected. The SF-36 questionnaire was implemented for measuring the domains related to physical health (PH) and mental health (MH). The growth frequency of weight gain in the Mexican (4.8%) and Chilean (10.9%) populations was observed during the second wave. The MH component decreased in the Mexican and the Chilean population (p < 0.05). Moreover, the MH decreased significantly according to the degree of confinement (p < 0.01). Although some sociodemographic factors were related to the presence of a very low score (<50 scores) for the MH component during the first wave, it is perceived as a higher relative risk during the second wave in both populations. The long confinement due to COVID-19 is associated to negative changes in nutritional and physical lifestyle behavior, affecting mainly the MH component.

Changes in Teleworking and Physical Activity Behaviors in the United States Before and After Emergence of COVID-19

OBJECTIVE

The aim of the study is to determine the prevalence of perceived decreases in three physical activity (PA) behaviors and meeting the PA guideline, by changes in telework.

METHODS

US workers ( N = 2393) reported teleworking and PA behaviors before and after COVID-19 emergence. Those reporting more and less telework were compared with those reporting stable telework on prevalence of (1) decreasing behaviors and (2) meeting the aerobic guideline (≥150 min/wk of moderate-intensity PA).

RESULTS

Compared with workers with stable telework, those with increased telework were more likely to report decreases in any PA (by 61%), active transportation (65%), and park use (52%). Workers who deceased telework were also more likely to report decreases in these behaviors. Groups were equally likely to meet the guideline.

CONCLUSIONS

Changes in teleworking status-either more or less-may be associated with decreased participation in PA behaviors.

Association of Physical Activity With SARS-CoV-2 Infection and Severe Clinical Outcomes Among Patients in South Korea

Importance

The association of moderate to vigorous physical activity (MVPA) with COVID-19 outcomes is unclear and needs to be investigated.

Objective

To identify the association of longitudinal changes in MVPA with SARS-CoV-2 infection and severe COVID-19 outcomes.

Design, Setting, and Participants

This nested case-control study used data from 6 396 500 adult patients in South Korean who participated in National Health Insurance Service (NHIS) biennial health screenings from period 1 (2017-2018) to period 2 (2019-2020). Patients were followed from October 8, 2020, until the diagnosis of COVID-19 or December 31, 2021.

Exposure

Moderate to vigorous physical activity was measured by self-report on questionnaires during both NHIS health screenings and calculated by adding the frequency (times per week) of each moderate (≥30 minutes per day) and vigorous (≥20 minutes per day) physical activity.

Main Outcomes and Measures

The main outcomes were a positive diagnosis of SARS-CoV-2 infection and severe COVID-19 clinical events. Adjusted odds ratio (aORs) and 99% CIs were calculated using multivariable logistic regression analysis.

Results

A total of 183 350 patients with COVID-19 (mean [SD] age, 51.9 [13.8] years; female, 89 369 [48.7%]; male, 93 981 [51.3%]) among 2 110 268 participants were identified. For participants with vs without COVID-19, the proportion of MVPA frequency at period 2 was 35.8% vs 35.9% for physically inactive, 18.9% vs 18.9% for 1 to 2 times per week, 17.7% vs 17.7% for 3 to 4 times per week, and 27.5% vs 27.4% for 5 or more times per week. Among unvaccinated, physically inactive patients at period 1, the odds for infection increased when engaged in MVPA 1 to 2 times per week (aOR, 1.08; 99% CI, 1.01-1.15), 3 to 4 times per week (aOR, 1.09; 99% CI, 1.03-1.16), or 5 or more times per week (aOR, 1.10; 99% CI, 1.04-1.17) at period 2. Conversely, among unvaccinated patients with MVPA of 5 or more times per week at period 1, the odds for infection decreased when engaged 1 to 2 times per week (aOR, 0.90; 99% CI, 0.81-0.98) or physically inactive (aOR, 0.80; 99% CI, 0.73-0.87) at period 2. The trend of MVPA and incident infection was mitigated when participants were fully vaccinated. Furthermore, the odds for severe COVID-19 showed significant but limited associations with MVPA.

Conclusions and Relevance

The findings of this nested case-control study show a direct association of MVPA with risk of SARS-CoV-2 infection, which was mitigated after completion of the COVID-19 vaccination primary series. In addition, higher levels of MVPA were associated with a lower risk of severe COVID-19 outcomes to limited proportions.

Short and mid-term characteristics of COVID-19 disease course in athletes: A high-volume, single-center study

INTRODUCTION

At the pandemic's beginning, significant concern has risen about the prevalence of myocardial involvement after SARS-CoV-2 infection. We assessed the cardiovascular burden of SARS-CoV-2 in a large cohort of athletes and identified factors that might affect the disease course. We included 633 athletes in our study on whom we performed extensive cardiology examinations after recovering from SARS-CoV-2 infection. More than half of the athletes (n = 322) returned for a follow-up examination median of 107 days after the commencement of their infection.

RESULTS

Troponin T positivity was as low as 1.4% of the athletes, where the subsequently performed examinations did not show definitive, ongoing myocardial injury. Altogether, 31% of the athletes' rapid training rebuild was hindered by persistent or reoccurring symptoms. Female athletes reported a higher prevalence of return to play (RTP) symptoms than their male counterparts (34% vs. 19%, p = 0.005). The development of long COVID symptoms was independently predicted by increasing age and acute symptoms' severity in a multiple regression model (AUC 0.75, CI 0.685-0.801). Athletes presenting with either or both cough and ferritin levels higher than >150 μg/L had a 4.1x (CI 1.78-9.6, p = 0.001) higher odds ratio of developing persistent symptoms.

CONCLUSION

While SARS-CoV-2 rarely affects the myocardium in athletes, about one in three of them experience symptoms beyond the acute phase. Identifying those athletes with a predisposition to developing long-standing symptoms may aid clinicians and trainers in finding the optimal return-to-play timing and training load rebuild pace.

Being Physically Active Leads to Better Recovery Prognosis for People Diagnosed with COVID-19: A Cross-Sectional Study

The regular practice of physical activity helps in the prevention and control of several non-communicable diseases. However, evidence on the role of physical activity in mitigating worsening clinical outcomes in people with COVID-19 is still unclear. The aim of this study was to verify whether different levels of physical activity provide protection for clinical outcomes caused by SARS-CoV-2 infection. A cross-sectional study was conducted with 509 adults (43.8 ± 15.71 years; 61.1% female) with a positive diagnosis of COVID-19 residing in Ribeirão Preto, São Paulo, Brazil. Participants were interviewed by telephone to determine the severity of the infection and the physical activity performed. Binary logistic regression was used to indicate the odds ratio (OR) of active people reporting less harmful clinical outcomes from COVID-19. Active people had a lower chance of hospitalization, fewer hospitalization days, less respiratory difficulty and needed less oxygen support. The results suggest that active people, compared to sedentary people, have a lower frequency of hospitalization, length of stay, breathing difficulty and need for oxygen support. These results corroborate the importance of public policies to promote the practice of physical activity, in order to mitigate the severity of the clinical outcomes of COVID-19.

Effects of physical activity on the severity of illness and mortality in COVID-19 patients: A systematic review and meta-analysis

Purpose: This systematic review and meta-analysis investigated the association between Physical activity (PA) before Coronavirus Disease 2019 (COVID-19) infection and the severity of illness and mortality in COVID-19 patients. Methods: A comprehensive search was undertaken to identify retrospective and nonrandomized controlled trial studies comparing the severity and mortality of COVID-19 infection among COVID-19 patients who had previously reported their participation in PA with those who had not. The databases searched were PubMed, Cochrane Library, Scopus, Science Direct, EMBASE, OPENGREY.EU, and ClinicalTrials.gov. The risk of bias was assessed using the Newcastle-Ottawa Scale. A random-effects model was used for determining pairwise meta-analyses. The protocol was registered with PROSPERO (CRD42021262548). Results: Eighteen studies met the inclusion criteria (5 cross-sectional, 12 cohort, and 1 case-control studies). All 1 618 680 subjects were adults. PA significantly decreased the risk of death in COVID-19 patients (odds ratio [OR] 0.34; 95% confidence interval [CI], 0.19-0.62; p < 0.001) and the risk of severe outcomes (OR 0.60; 95% CI, 0.48-0.76; p < 0.001). Subgroup analysis showed that PA for ≥150 min/wk at a moderate intensity or ≥75 min/wk at a vigorous intensity reduced the risks of severity and mortality. Vigorous PA reduced mortality risk, whereas moderate to vigorous PA reduced the risks of severity and mortality. Conclusion: PA before infection might reduce severity and mortality in COVID-19 patients, especially PA ≥ 150 min/wk of moderate activity or ≥75 min/wk of vigorous activity. However, careful interpretations should be considered due to the difference in PA patterns and severity definitions among included studies. This finding implies that engaging in regular PA, even in different patterns, has beneficial effects on the severity and mortality of COVID-19 patients.

The role of physical activity in the clinical outcomes of people diagnosed with Covid-19: A systematic review

Objective

This review aimed to compile the evidence on PA and clinical outcomes of people receiving a positive diagnosis of covid-19.

Design

Systematic review.

Methods

The search was performed in five databases: EMBASE, MEDLINE via PubMed portal, Scopus, SPORTDiscus via EBSCO platform, and Web of Science. In addition, the "gray" literature was searched through Google Scholar and medRxiv published between January 2020 and July 2022. Studies were assessed for risk of bias, with the extraction of relevant data. Our search revealed a total of 10,028 studies.

Results

After applying the eligibility criteria 32 studies were included. Thirty-one studies were at low to moderate risk of bias. Physically active individuals, who were diagnosed with covid-19, presented attenuation of clinical outcomes, such as decreased risk of hospitalization, recovery time, number of symptoms, severity, and ICU and death when compared to individuals with low levels of PA or classified as sedentary.

Conclusions

Physically active individuals when diagnosed with covid-19 may have decreased risk of several clinical outcomes related to covid-19, including but not limited to hospitalization and number of symptoms. Public health authorities should develop strategies and initiatives that promote safe PA environments to improve the clinical prognosis of people diagnosed with covid-19.

Study registration

Open Science Framework (OSF), DOI registry 10.17605/OSF.IO/PV6NF. It can be consulted through the access link: https://doi.org/10.17605/OSF.IO/PV6NF, October 07, 2021.

Physical activity and risk of infection, severity and mortality of COVID-19: a systematic review and non-linear dose-response meta-analysis of data from 1 853 610 adults

OBJECTIVE

To quantify the association between physical activity and risk of SARS-CoV-2 infection, COVID-19-associated hospitalisation, severe illness and death due to COVID-19 in adults.

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

Three databases were systematically searched through March 2022.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Peer-reviewed articles reporting the association between regular physical activity and at least one COVID-19 outcome in adults were included. Risk estimates (ORs, relative risk (RR) ratios or HRs) were extracted and pooled using a random-effects inverse-variance model.

RESULTS

Sixteen studies were included (n=1 853 610). Overall, those who engaged in regular physical activity had a lower risk of infection (RR=0.89; 95% CI 0.84 to 0.95; I2=0%), hospitalisation (RR=0.64; 95% CI 0.54 to 0.76; I2=48.01%), severe COVID-19 illness (RR=0.66; 95% CI 0.58 to 0.77; I2=50.93%) and COVID-19-related death (RR=0.57; 95% CI 0.46 to 0.71; I2=26.63%) as compared with their inactive peers. The results indicated a non-linear dose-response relationship between physical activity presented in metabolic equivalent of task (MET)-min per week and severe COVID-19 illness and death (p for non-linearity <0.001) with a flattening of the dose-response curve at around 500 MET-min per week.

CONCLUSIONS

Regular physical activity seems to be related to a lower likelihood of adverse COVID-19 outcomes. Our findings highlight the protective effects of engaging in sufficient physical activity as a public health strategy, with potential benefits to reduce the risk of severe COVID-19. Given the heterogeneity and risk of publication bias, further studies with standardised methodology and outcome reporting are now needed.

PROSPERO REGISTRATION NUMBER

CRD42022313629.

Physical activity and COVID-19. The basis for an efficient intervention in times of COVID-19 pandemic

The Coronavirus Disease 2019 (COVID-19) pandemic has shocked world health authorities generating a global health crisis. The present study aimed to analyze the different factors associated with physical activity that could have an impact in the COVID-19, providing a practical recommendation based on actual scientific knowledge. We conducted a consensus critical review using primary sources, scientific articles, and secondary bibliographic indexes, databases, and web pages. The method was a narrative literature review of the available literature regarding physical activity and physical activity related factors during the COVID-19 pandemic. The main online database used in the present research were PubMed, SciELO, and Google Scholar. COVID-19 has negatively influenced motor behavior, levels of regular exercise practice, eating and nutritional patterns, and the psychological status of citizens. These factors feed into each other, worsening COVID-19 symptoms, the risk of death from SARS-CoV-2, and the symptoms and effectiveness of the vaccine. The characteristics and symptoms related with the actual COVID-19 pandemic made the physical activity interventions a valuable prevention and treatment factor. Physical activity improves body composition, the cardiorespiratory, metabolic, and mental health of patients and enhancing antibody responses in vaccination.

Impact of Physical Activity and Exercise on the Epigenome in Skeletal Muscle and Effects on Systemic Metabolism

Exercise and physical activity induces physiological responses in organisms, and adaptations in skeletal muscle, which is beneficial for maintaining health and preventing and/or treating most chronic diseases. These adaptations are mainly instigated by transcriptional responses that ensue in reaction to each individual exercise, either resistance or endurance. Consequently, changes in key metabolic, regulatory, and myogenic genes in skeletal muscle occur as both an early and late response to exercise, and these epigenetic modifications, which are influenced by environmental and genetic factors, trigger those alterations in the transcriptional responses. DNA methylation and histone modifications are the most significant epigenetic changes described in gene transcription, linked to the skeletal muscle transcriptional response to exercise, and mediating the exercise adaptations. Nevertheless, other alterations in the epigenetics markers, such as epitranscriptomics, modifications mediated by miRNAs, and lactylation as a novel epigenetic modification, are emerging as key events for gene transcription. Here, we provide an overview and update of the impact of exercise on epigenetic modifications, including the well-described DNA methylations and histone modifications, and the emerging modifications in the skeletal muscle. In addition, we describe the effects of exercise on epigenetic markers in other metabolic tissues; also, we provide information about how systemic metabolism or its metabolites influence epigenetic modifications in the skeletal muscle.

Impact of Exercise on Gut Microbiota in Obesity

Physical activity, exercise, or physical fitness are being studied as helpful nonpharmacological therapies to reduce signaling pathways related to inflammation. Studies describing changes in intestinal microbiota have stated that physical activity could increase the microbial variance and enhance the ratio of Firmicutes/Bacteroidetes, and both actions could neutralize the obesity progression and diminish body weight. The aim of this review is to provide an overview of the literature describing the relationship between physical activity profiles and gut microbiota and in obesity and some associated comorbidities. Promoting physical activity could support as a treatment to maintain the gut microbiota composition or to restore the balance toward an improvement of dysbiosis in obesity; however, these mechanisms need to be studied in more detail. The opportunity to control the microbiota by physical activity to improve health results and decrease obesity and related comorbidities is very attractive. Nevertheless, several incompletely answered questions need to be addressed before this strategy can be implemented.